MedicaidReimbursementHigh impact
Fiscal Year 2020 Rates for the Community First Choice and Community Personal Assistance Programs
Maryland Medicaid·MD·Provider Transmittal
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
This policy establishes Fiscal Year 2020 payment rates for Community Personal Assistance Services (CPAS) program, effective July 1, 2019. Six service codes have updated hourly rates and 15-minute unit rates that must be used for all claims submitted under Maryland's CPAS program. Billing teams must immediately update rate tables in their billing systems to reflect these new rates or claims will be reimbursed at incorrect amounts.
Action Required
Immediately: Billing team must update billing system fee schedules for Maryland CPAS program with the following rates: W5527 ($18.03/hr or $4.5075 per 15-min), W5528 ($12.02/hr or $3.005 per 15-min), W5526 ($65.66/hr or $16.415 per 15-min), W5524 ($65.66/hr or $16.415 per 15-min), W5525 ($65.66/hr or $16.415 per 15-min), and W5529 ($88.98/hr or $22.245 per 15-min). Verify that claims for these services are calculating reimbursement using 15-minute unit rates. Confirm compliance with COMAR 10.09.20 billing limitations. Failure to update rates will result in claim underpayment or denial for CPAS services rendered on or after July 1, 2019.